7 Medical Reasons You Shouldn’t Ignore Heartburn

Updated: Jun. 01, 2021

If you’ve ever been pregnant, had spicy food, eaten too much, or just generally been an adult human being, you’ve probably had heartburn at some point. Usually, it’s nothing to be alarmed about, but there are instances when you shouldn’t ignore it.

Man having chest pain, heart attack.

Heartburn can mimic a heart attack

The symptoms of heartburn can be similar to those of a heart attack or angina—a crushing type of chest pain that is caused by decreased blood flow to the heart. There are some rules of thumb for differentiating between heartburn and a heart attack. For instance, heartburn typically gets worse when lying down and can leave a sour taste in your mouth. However, there are exceptions. “Even experienced physicians can’t always tell the difference from the symptoms,” says Albert Wu, MD, director of the Center for Health Services and Outcomes Research at Johns Hopkins School of Public Health in Baltimore, MD. “That’s why if you have persistent chest pain and aren’t sure what it’s from, you should call 911 or go to the emergency room.” (Here are other reasons you may be experiencing chest pain.)

Woman wearing a plaid shirt hunched over clutching her stomach.

Your heartburn could actually be gallstones

Gallstones are pieces of hardened digestive fluid that can form in your gallbladder, a small organ to the right of your abdomen. A gallstone blocking your bile duct can cause cramping in the middle or upper-right side of your abdomen. Often, the pain occurs just after eating—similar with heartburn. If you are having consistent stomach pain after eating that doesn’t approve after taking an antacid, contact your physician. These are the 8 foods gastroenterologists try to never eat.

Man in a button-down blue dress shirt holding his right hand over his heart.

Severe heartburn could be a symptom of GERD

All heartburn is gastroesophageal reflux or GER, meaning it’s when stomach acid or stomach content flows back into your esophagus. The reflux irritates the lining of the esophagus. If it’s severe enough or chronic enough, heartburn could become be GERD (short, for gastroesophageal reflux disease). If you are experiencing heartburn or acid reflux at least twice a week, or if it is interfering with your daily life, it’s time to see a doctor. Your body will thank you for trying these GERD home remedies.

Woman holding her neck with her right hand.

GERD can lead to Barrett’s esophagus

If left untreated, GERD “can lead to Barrett’s esophagus, precancerous changes to the lining of the esophagus due to chronic acid,” says Dr. Wu, adding that GERD rarely leads to esophageal cancer.

Bottle of pills opening up into a person's hand.

The pain you think is heartburn could be a stomach ulcer

A stomach ulcer is a sore found in the stomach lining. The pain of a stomach ulcer can be felt in the upper abdomen and up into the chest, and at times can be similar to the pain of heartburn. “An untreated stomach ulcer can bleed if it erodes into a blood vessel, and even erode through the stomach wall and cause a perforation,” says Dr. Wu. “If the ulcer is near the junction between the stomach and intestine, it can scar and cause blockage.” While some stomach ulcers heal on their own, some require antibiotics and even surgery. Make sure you know the 9 signs your heartburn might be allergies instead.

Group of surgeons and surgeon's assistants underneath a light, using operating tools.

Your heartburn could be due to a hiatal hernia

Your diaphragm normally has a small opening through which your esophagus passes on its way to the stomach. A hiatal hernia occurs when your stomach pushes up through this hole in your diaphragm. A large hiatal hernia can cause food and acid to back up into your esophagus, causing heartburn. If you are having persistent or severe heartburn signs or symptoms, you should see a doctor. While usually medication is enough to control it, sometimes surgery may be needed to correct it.

A family sitting around a table eating a meal together, while one woman is clutching her stomach as if in pain.

Severe heartburn can lead to esophagitis

Esophagitis is inflammation of the esophagus, often caused by stomach acids backing up into the esophagus. This can cause painful, difficult swallowing and chest pain. If untreated, esophagitis can damage the esophagus’s lining and lead to complications such as scarring and difficulty swallowing. If your heartburn symptoms last more than a few days, don’t improve with over-the-counter antacids, make eating difficult, are accompanied by flu-like symptoms, or are accompanied by shortness of breath or chest pain that occurs shortly after eating, get checked by a doctor. Try one of these natural home remedies for heartburn relief.